The government has admitted the NHS in England does not have enough nurses and doctors to keep all its services running if there is a third spike in coronavirus cases as leaked figures show the number of staff off work because of the virus rising.
An analysis of the impact of coronavirus, released by Downing Street on Monday, warned that even with a 6 per cent growth in NHS staff since August 2019 and extra funding “there is a trade-off between the NHS’s ability to deliver Covid-19 and non-Covid-19 care in the event that Covid-19 hospitalisations rise”.
It also warned of the psychological effects on staff saying: “It would be expected that higher rates of post-traumatic stress disorder (PTSD) would be seen amongst health and social care staff.”
The national lockdown in England is due to end on Tuesday night with MPs voting on introducing new stricter local tiers of restrictions to keep pressure on the spread of the virus. The latest data showed a total of 12,330 positive cases and 205 Covid deaths reported on Monday.
New leaked NHS data for England on Monday shows more than 82,000 NHS staff are absent from work with more than two-fifths, 42 per cent, linked to coronavirus either due to sickness or because they need to self-isolate.
This includes almost 27,000 nurses and 4,000 doctors absent from NHS wards.
Hospital leaders reiterated the strain the NHS was under in a briefing to MPs ahead of the vote on local tier restrictions on Tuesday.
NHS Providers, which represents hospital trusts, said the health service was facing a unique set of pressures as it looked after Covid-19 patients, those needing emergency care and patients caught up in the backlog of operations caused by the first wave of the virus.
Workforce pressures are the key weakness for hospitals as they head into winter. Some hospitals have already begun stretching nurse to patient ratios to dangerous levels because of the lack of staff on wards.
Mike Adams, England director for the Royal College of Nursing, told The Independent: “The government’s own impact assessment shows that the NHS has been able to recruit quickly NHS staff in some areas since last year, but only in small numbers. Many experienced nurses left before this pandemic started and they are not easily replaced.
“The government expects our overburdened workforce to fill in the gaps and push through this winter but the intolerable pressure of such demand could see nursing staff psychologically and physically burned out.”
Across England the numbers of coronavirus patients in hospital and on intensive care have been falling in recent days as the effect of the national lockdown drives down infections.
But some hospitals are still struggling to cope. The Royal Stoke University Hospital has been forced to move some critical care patients to other hospitals because of a surge in cases with its intensive care unit on the highest incident level.
NHS Providers chief executive Chris Hopson said: “It’s important that MPs understand the true extent of pressures faced by the NHS as they consider the new tiered restrictions.
“National statistics tell only part of the story. In reality the situation for trusts is much more difficult. Trust leaders understand only too well the impact of these restrictions on people’s livelihoods and liberties and on their mental health.
“Vaccines, therapeutic drugs and mass scale rapid turnaround testing offer a clear way out of this next spring.
“But there is an immediate need to get through winter, avoiding a damaging third surge in infections with the virus, and ensuring the NHS is able to provide appropriate high quality care for all patients, Covid and non-Covid.”
The Christmas and January period is usually when hospitals can experience the peak of winter crisis with demand from sick patients overwhelming A&E departments, leaving many patients waiting on trolleys in corridors for long periods.
Some hospitals in Manchester have already reported dozens of 12-hour trolley waits and some patients in A&E for longer than 24 hours. In Birmingham, hospital bosses have taken the decision to turn away non-emergency patients because of ambulances facing long delays.
NHS Providers said the current national statistics did not reflect the true situation hospitals were facing.
It said many trusts had had to remove beds and reduce capacity by 20 per cent in order to keep patients at a safe distance from each other to prevent infection with coronavirus. Planned surgery was taking longer than usual.
It added that A&E demand was down on normal years but there was a higher number of patients presenting to emergency departments who were sicker and needed a bed.
The increase in staff absence caused by coronavirus and the lack of rapid testing of staff was also hampering hospitals ability to run services efficiently.
It added that the data for patients in intensive care units was not a good indicator because many are now being looked after on general wards rather than being ventilated in intensive care.
The Nightingale hospitals are also not an option to relieve pressure on the NHS as hospitals have to provide staff to work there – exacerbating their existing shortages.